1. September, 2005What IHE Delivers 1 IHE Changing the Way Healthcare Connects in HOSPITALS HIMSS Interoperability Showcase February 2007 Micha Coleman (Siemens), Geert Claeys (Agfa), John Moehrke (GE)

2. 2 IHE – The Business Case for Hospitals System Integration, the hospital nightmare: An average hospital has 20 to 60 health IT systems from 8 to 15 vendors. Systems are pair-wise integrated, through locally specified solutions based on customized standards. It is expensive, complex and hard to maintain.

3. 3 IHE – The Business Case for Hospitals Re-engineering System Integration : Leverage standards-based, robust and innovative solutions refocus customization to value-add Reduce RFP costs with common guidelines in purchasing and integrating systems that deliver these solutions It works, IHE did it with your vendors ! Lets look at specific solutions….

4. 4 Growth in IHE Domains Radiology (18 profiles) IT Infrastructure for Healthcare (20 profiles) Cardiology (7 profiles) Laboratory (6 profiles) Radiation Oncology (3 profiles) Patient Care Coord. (5 profiles) Patient Care Devices (3 profiles) Pathology Eye Care (4 profiles) 1999 Over 200 vendors involved world-wideOver 200 vendors involved world-wide 8 Technical Frameworks8 Technical Frameworks 64 Integration Profiles64 Integration Profiles Testing at Connectathons world-wideTesting at Connectathons world-wide Demonstrations at major conferences world-wideDemonstrations at major conferences world-wide Each domain serves part of the hospital IT interoperability Veterinary Endoscopy Pharmacy Quality 200020012002200320042005200620072008

5. 5 IHE Model Actors in precisely defined roles Abstracts a specific function of information system Abstracts a specific function of information system …Executing precisely defined transactions Using existing standards Using existing standards ……To solve real world interoperability problems Specifying Integration Profiles Specifying Integration Profiles

6. 6 IHE Technical Frameworks Implementation Guide for each Integration Profile An Integration Profile : A Set of Actors A Set of Actors Exchanging Transactions Exchanging Transactions Use cases Process Flows For each transaction: Std referenced Std referenced Options specified Options specified Mapping required Mapping required ActorsTransactions

7. 7 IHE Solutions within the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care

8. 8 Cath Lab Workflow 1 2 3 4 5 6 7 8 9 10 11 IHE Cath Workflow Profile includes Electrophysiology lab Error prone data entry: Multiple re-entry of Patient ID Uncoordinated with Hospital Information System Unidentified patients (emergency) Results fragmented across systems Inconsistently time-tagged Custom solutions needed for data sharing Difficult to manage Un-ordered cath exams Change of rooms during procedure Ad hoc scheduling of cath labs The Cure for:

9. 9 Echo Workflow Need to solve the drive-by echo ? Cardiologist to sonographer in CCU: While youre here, do a TTE on bed 3 Unordered, unscheduled exam Machine disconnected from network Stress echo, need more automation ? After exam, sonographer creates new quad displays of stages and views No intrinsic value add Data is redundantly copied to storage IHE Echo Workflow Profile

10. 10 Stress Workflow ~85% of stress tests are multi- modality (ECG + imaging) ~0% of current architectures manage ECG and imaging workflow and results in an integrated manner Poor adherence to ACC/ASNC nuclear image display requirements IHE Stress Testing Profile and IHE Nuclear Medicine Image Profile

11. 11 IHE Solutions within the Enterprise Cardiology Radiology CardiologyLaboratory Enterprise IT Infrastructure Enterprise IT Infrastructure EMR - HIS RIS PACS Img Acq CIS CathECG LIS Auto Mgr Analyzer -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology Cardiology Integration Profiles Cardiac Catheterization Lab Workflow Echocardiography Lab Workflow Retrieve ECG for Display Displayable Reports Cath and Echo Evidence Documents Implanted Device ObservationseMPI User Auth

12. 12 IHE Solutions within the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care

13. 13 Laboratory Scheduled Workflow - Value Proposition A comprehensive workflow approach Address specimen linkage most lab specialties: Blood gases, Chemistry, Hematology, Immunology, Laboratory, Microbiology, Mycobacteriology, Mycology, Serology, Toxicology, Virology. Provides workflow improvement Increases continuity and integrity of clinical data Decreases user need for manual tasks. Spans ordering, conformity of specimens, lab automation, results delivery. Externally placed order with identified specimens Externally placed order with specimens unidentified or to be collected by the laboratory Internally placed order with specimens identified by third party or collected by the laboratory

14. 14 IHE Solutions within the Enterprise Laboratory Radiology CardiologyLaboratory Enterprise IT Infrastructure Enterprise IT Infrastructure EMR - HIS RIS PACS Img Acq CIS CathECG LIS Auto Mgr Analyzer -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care Laboratory Integration Profiles Laboratory Scheduled Workflow Laboratory Barcode Labeling Laboratory Point Of Care Testing Laboratory Device Automation Laboratory Code Set DistributioneMPI User Auth

15. 15 IHE Solutions within the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care

16. 16 Scheduled Workflow & patient Info reconciliation Backbone of IHE Radiology: Integrates Registration, Scheduling, Acquisition Workflow and Image Content Preserve Order Continuity, improve Demographic Integrity, synchronized Worklists Reliable Storage, Improve Order Tracking Reduce Integration Effort at Site Combines use of HL7 and DICOM standards

17. 17 IHE Solutions within the Enterprise Radiology Radiology CardiologyLaboratory Enterprise IT Infrastructure Enterprise IT Infrastructure EMR - HIS RIS PACS Img Acq CIS CathECG LIS Auto Mgr Analyzer -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye CareeMPI User Auth Radiology Integration Profiles Radiology Scheduled Workflow Patient Information Reconciliation Access to Radiology Information Portable Data for Imaging Consistent Presentation of Images Key Image Note Presentation of Grouped Procedures Evidence Documents Audit trail and Node Authentication (Rad option) Teaching Files and Clinical Trials Export Post-processing Workflow Reporting Workflow Charge Posting Simple Image and Numeric Reports Media Import Reconciliation Workflow How to use IHE ? IHE Radiology IHE RadiologyHandbook

18. 18 IHE Solutions within the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care

19. 19 Patient Administration Mgt (PAM) CCHIT plan for 2009 Coordinates exchange of patient registrations, updates, and movements for all clinical areas Information may be received and processed by consuming applications in any clinical domain Optionally allows unambiguous updating of historic patient movement events Demographic and encounter tracking works in both inpatient and ambulatory care settings Standardizes on HL7 V2.5 and its conformance structures

20. 20 Patient Administration Management Actor & Transaction: flexibility and compatibility Flexible Actor grouping

21. 21 Patient Demographics Query – HL7 V2.5 Adopted b y HITSP Patient Demographics Supplier Patient Demographics Consumer Patient Demographics Query Patient Demographics and Visit Query Registration system or departmental system that is connected on demand to it. Diverse systems including bedside monitors, physician office systems, lab applications, mobile blood bank registries; might be any system at the point of care.

22. 22 Patient Identifier Cross-referencing-HL7 V2.5 Adopted b y HITSP Registration system or eMPI Registration system Departmental or Outpatient system

23. 23 IHE Solutions within the Enterprise IT Infrastructure (Enterprise) Radiology CardiologyLaboratory RIS PACS Img Acq CIS CathECG LIS Auto Mgr Analyzer -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye CareeMPI User Auth EMR - HIS IT Infrastructure Integration Profiles Patient Administration Management Patient Demographics Query Patient Identifier Cross-referencing Retrieve Information for Display Enterprise User Authentication Consistent Time Patient Synchronized Applications Audit Trail and Node Authentication Personnel White Pages Enterprise IT Infrastructure Enterprise IT Infrastructure

24. 24 IHE Solutions for extending the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care Outpatient Clinic EMR Pactice Mgt Partner Clinic EMR Pactice Mgt Practice EMR Partner Clinic EMR Pactice Mgt Partner Clinic EMR Pactice Mgt Practice EMR Partner Practices EMR Pactice Mgt Index of shared patients records Accessing: Patient ChartsPatient Charts Laboratory, Radiology resultsLaboratory, Radiology results Stark Relaxation Stark Relaxation

25. 25 IHE Solutions for Extending the Enterprise Integrated Delivery Networks eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care Outpatient Clinic EMR Pactice Mgt Partner Clinic EMR Pactice Mgt Practice EMR Partner Clinic EMR Pactice Mgt Partner Clinic EMR Pactice Mgt Practice EMR Partner Practices EMR Pactice Mgt Index of shared patients records Integration Profiles for an IDN Cross-Enterprise Document Sharing Patient Id Cross-Referencing Patient Demographics Query Audit Trail and Node Authentication Consistent Time Sharing of Medical Summaries Sharing of Lab Reports Sharing of Imaging Information Sharing of Scanned Documents See presentation: IHE Changing the Way Healthcare Connects Communities

26. 26 2008 HIMSS Interoperability Showcase

27. 27 As a Provider or Vendor Contributor Offer Clinical Use Case Input to Drive IHE Profile Development Become a member of relevant domains Planning or Technical Committees Become a member of relevant Regional/National Committees Help to shape IHEs future direction As a Vendor Participant Respond to Public Comments of Domain Supplements Attend the June Educational Workshop Participate in Connect-a-thons and Demonstrations As a Provider/Consultant Participant Respond to Public Comments of Domain Supplements Attend the June Educational Workshop Attend Demonstrations and include IHE Integration Profiles in your RFPs and Integration Projects. How can I participate?

28. 28 What can you do? Attend the IHE Domain specific sessions in these Theaters during HIMSS 2007 (Orange sessions) Learn about IHE, www.ihe.net www.ihe.net Insist on relevant IHE profiles compliance in your RFPs and contract documents: Select Integration Profiles, and Appropriate Actor(s) Select Integration Profiles, and Appropriate Actor(s) Ask vendors for their products IHE Integration Statements. Ask vendors for their products IHE Integration Statements. Need more interoperability ? Contribute to IHE Committees Contribute to IHE Committees

29. 29 IHE Web site: www.IHE.net Frequently Asked Questions Integration Profiles in Technical Frameworks: See Volume 1 of each TF for Use cases Cardiology Eye Care IT Infrastructure Laboratory Patient Care Coordination Patient Care Devices Pathology Quality Radiation Oncology Radiology Connectathon Result: www.ihe.net/Events/connectathon_results.cfm Vendor Products Integration Statements

30. September, 2005What IHE Delivers 30